The University of Michigan School of Dentistry - Victors for Dentistry (1962–2017): Decades of Innovation and Discovery

The Transition Committee

Duderstadt also announced that he had named Dr. William Kotowicz as interim dean. As interim dean, Kotowicz had been asked to chair a Transition Committee. This committee would work closely with the provost to chart the future course of the school. Duderstadt emphasized that during this time of transition, the school needed to assess its strengths and weaknesses, develop a vision for its future, cut the number of departments, revise its curriculum, and find ways to become more integrated with the rest of the campus. “The school continues to be somewhat isolated from the rest of the campus in general and the other health science disciplines in particular,” Duderstadt said.

Christian Stohler, who was then the chair of the Department of Occlusion, says he recalls the Duderstadt presentation very well:

Duderstadt also stressed the need for quick, effective action.

Interim Dean

On July 1, 1987, Kotowicz became interim dean and head of the Transition Committee. Duderstadt said he named Kotowicz to both positions “because he enjoys an unusual degree of respect and support across broad segments of the school. His recent service as a member of the school’s Executive Committee provides both an appropriate perspective and important credibility for this important role.” Duderstadt concluded by “asking you as faculty to give full and strong support to Professor Kotowicz and the Transition Committee as they work with you to achieve change and restore the school to a position of true national leadership.”[1]

Duderstadt, who was named president of the U-M in 1988, later reflected on that appointment:

A Common Purpose and Hard Work

The Transition Committee led by Kotowicz included faculty members Kenneth McClatchey, Charlotte Mistretta, Raymond Fonseca, Joseph Regezi, and John Lillie. The members of the committee came from both inside and outside the dental school and gelled as a team to tackle this daunting yet critically important task. The committee was charged with the task of taking a top-to-bottom look at all dental school operations and creating strategies to address the challenges it faced.[3]

The first charge the committee had to address was to streamline the organizational structure and function of the school by reducing the number of departments. Confronting the issue head on, 18 departments were consolidated into 6. Reducing the number of departments “put Bill Kotowicz in a difficult position because it was tough to tell some faculty members that they were no longer department chairs,” said Dr. John Drach. “Bill did his best not to alienate the older more established faculty members because they were experts in their field and essential to the school.”

The Transition Team: (L-R, Back) Raymond Fonseca, Joseph Regezi, John Lillie. (L-R, Seated) Kenneth McClatchey, William Kotowicz and Charlotte Mistretta.

Pending faculty approval, the new departments were named as were interim chairs. The new departments were the following: (1) Prosthodontics (Brien Lang), (2) Restorative Dentistry—included endodontics, occlusion, and periodontics (Joseph Dennison), (3) Biologic and Materials Sciences (John Drach), (4) Oral Medicine, Pathology and Surgery (Raymond Fonseca), (5) Prevention and Health Care Delivery—included and dental hygiene (Robert Bagramian), and (6) Orthodontics and Pediatric Dentistry (James McNamara).[4]

Dr. Charlotte Mistretta

Dr. Charlotte Mistretta, a member of the Transition Committee, remembers the countless early morning meetings members of the Transition Committee attended to address their charge. The members met regularly for three hours on Monday mornings for over a year and frequently at additional times.

Reflecting back on the work of the committee, Mistretta recalls:

We were given a formidable task and a relatively short timeline to get the job done. Our backgrounds and academic and professional focuses were varied but remarkably, we gelled and worked extremely well together. We set to task and a year after our initial meeting we presented our plans for administrative and department restructuring, curriculum revisions, faculty appointments and promotions, a full set of Bylaws, budgeting and financial planning and research operations to a distinguished external advisory committee.

These external experts included Howard Bailit, senior vice president with Aetna Health Plans, George Keller, senior vice president with Barton-Gillet Company and Bernard Machen, associate dean at the University of North Carolina. The external advisory committee was impressed with the plans they reviewed and lauded our efforts to reconfigure the administrative structure and redesign the curricular strategies to insure the school would regain its academic posture within the university, revitalize its research enterprise and employ a sustainable budget model moving forward.

The feedback from the external advisory committee validated all of the hours of hard work and thoughtful deliberation the committee members invested in the transition process. The Transition Committee could succeed because we had an uncommon, outstanding leader and “person for the times” in Bill Kotowicz, and the full backing from the University’s Central Administration in our decisions. (Personal communication, May 25, 2017)

Administrative Reorganization

Consolidating the department structure meant each department was responsible for more areas of study within the department. Administrative operations and decision making were decentralized, giving the departments tremendous authority to develop their internal organizational structure, budgets, research, faculty development, and fundraising. “This environment supports mentoring and career development and enhances our ability to recruit high-quality faculty. In addition, evidence of that success is validated by how frequently our administrators and faculty members are recruited by other dental schools, often to be deans,” Kotowicz said.[5]

The school also rethought how academic and other administrative units would collaborate and share resources. The Transition Committee organized administrative duties according to function: admissions, student affairs, curricular matters, graduate and postgraduate education, clinical and hospital affairs, computer operations, continuing education, and research. Kotowicz said that research would become a high priority at the school and that faculty would be expected to invest more time and resources in research.[4]

Another important objective tackled during the transition process was to amend the school’s faculty appointment policies and bring them in line with university-wide promotion and tenure procedures. A later addition of the “clinical track” further addressed the teaching needs of the school as well as provided an advancement series for the clinical faculty. (Personal communication, September 18, 2017)

Musings on Major Changes

Dr. Christian Stohler

Dr. Christian Stohler joined the U-M School of Dentistry as an associate professor in 1984 and chaired the Department of Biologic and Materials Sciences from 1996 until 2003, when he was named dean of the University of Maryland dental school. Since 2013, Stohler has been dean of Columbia University’s College of Dental Medicine.

In a March 10, 2015 personal communication Stohler said:

[The Transition Committee] helped everyone focus on what needed to be done. But committee members had a horrible job. They had to develop a new leadership structure that made a lot of people unhappy, especially reducing the number of departments from 18 to six. But there was no way a person could manage a school with so many departments. The school had to develop a structure that was more efficient and led to more accountability.

Stohler himself was directly affected:

I was one of those who was no longer a department chair. I remember submitting my resignation as chair of the Department of Occlusion on a Friday afternoon and the following Monday morning I was part of another department (Restorative Dentistry).

The school’s transformation was not a one-, two- or three-year event. Stohler said:

It took about 10 or 11 years to accomplish. . . . It was very hard work. It was painful. But it was a major achievement that was very important to the school and the university. The Transition Committee tried to create something visionary that would help both the school and the university well into the future. Bill Kotowicz, as head of the Transition Committee, and other committee members did a remarkable job.

Dr. Jed Jacobson concurs:

The reorganization, or the transition, the school experienced was one of the most difficult, yet meaningful events I witnessed when I was at the school. I think it made everyone realize that, we as a school, had to bring value to the University of Michigan and become an integral part of the fabric of the university. (Personal communication, July 23, 2015)

Dr. Jed Jacobson

A New Curriculum Emerges

When the Transition Committee was evaluating the school’s infrastructure and programs in 1987, it expressed concern that the predoctoral curriculum had not changed substantially in 20 years. A seven-member Curriculum Task Force (CTF) was convened to take on the task of reviewing and revising the DDS curriculum.[6]

The CTF, made up of representatives from each of the six new departments, took a multi-tiered approach, assessing the strengths and weaknesses of the existing curriculum, setting guidelines to develop a new program of study, then designing the new curriculum, and determining how best to implement it. The CTF proposed that the time scheduled to deliver this curriculum be increased from 4,500 hours to 4,700 with more time available to the students for the mastery of clinical skills. They also stressed that the number of hours the students were in contact with the curriculum be held at 32 each week. To achieve this goal and provide more time for clinical instruction, the CTF suggested the following: (1) extending the academic year, (2) reducing redundancies in didactic clinical material facilitated by the consolidation of departments, and (3) integrating and resequencing the basic science curriculum.

Dr. John Lillie—chair of the Curriculum Task Force, associate professor of dentistry, and professor of anatomy and cell biology—explained the changes in the September 12, 1988, issue of The University Record. “Most of the traditional curricula were based on specialties of dentistry,” he said. “We’ve tried to integrate those disciplines and build toward a new concept of comprehensive treatment planning and patient care.”

Dr. John Lillie led the curriculum task force that designed the new curriculum.

A drafting table was used to map out the complexities of the new curriculum.

Goals of the New Curriculum

The new predoctoral curriculum embraced four main goals and the school’s faculty and staff were resolute in their commitment to realize each of them. Earlier clinical experiences, year-round classes and clinics, and the initiation of a new comprehensive patient care program emphasized the development of patient care and practice management skills.[7]

Each year from 1988 to 1991, segments of the new curriculum were submitted to the full-time faculty for review and approval. Then, as each new segment was finished, students and faculty provided feedback on course structure and how the course fit with those around it. Data from these evaluations helped identify content overlap or gaps and were useful to make adjustments before the course was offered next. By the fall of 1991, the new curriculum was fully implemented and patient-centered comprehensive care became a focal point of every dental student’s clinical experience.[8]

Student Research Flourishes

The U-M School of Dentistry has a long-standing history of engaging students at all levels in research activities through both externally funded formal research training programs and participation in faculty research projects.

At the predoctoral level, the students benefited from a training grant entitled “Short-term training in health professional schools” funded by the National Institute for Dental Research (NIDR). The grant supported approximately 12–15 students per year and that number was generally matched by the School of Dentistry.

Together these funding sources supported as many as 30 Student Research Program participants each year. The student projects were presented at the annual Table Clinic program, later to become Research Day. Many of these student projects were submitted to and accepted for presentation at the annual International and American Associations for Dental Research (IADR/AADR) meetings.

In 1987, the AADR created a student research fellowship program in an effort to encourage and support predoctoral student research in U.S. dental schools. School of Dentistry students were encouraged to apply for these fellowships and some applications were funded. As a member of the School of Dentistry’s Fellowship Review Committee, Biologic and Materials Sciences faculty member Dr. Dennis Lopatin observed that the successful applicants were generally the individuals who had worked on a project for a year, were conversant in the scientific literature related to their project, and worked closely with their faculty mentors during the application preparation process. As a result, the applications were very strong and successful. (Personal communication, May 19, 2017)

Lopatin and the Review Committee set a policy whereby all Student Research Program participants who wished to participate in the program for a second year were required to apply for an AADR Student Research Fellowship. The U-M student applicants became so successful in obtaining AADR fellowships that after several years, when Michigan student scientists were awarded the lion’s share of the fellowships, AADR instituted a rule that limited the number of fellowships awarded to any one school.

In 1988, Lopatin and Jed Jacobson assumed responsibility for the management of the Student Research Program which until then was run primarily during the summer break of about two and a half months. With the implementation of the new curriculum, the summer break was now shortened to six weeks and staggered by class year. This seriously impacted the Student Research Program and jeopardized NIDR support due to fewer weeks available for students to actually complete a research project.

Lopatin, principal investigator on an NIDR short-term training grant and other faculty colleagues, developed a plan that integrated aspects of the 10-week summer student research program into the DDS curriculum. Now, throughout the academic year, students worked with their mentors to develop their research protocols and attend seminars on various aspects of research. The continuous, ongoing research experience, combined with an intense lab or clinic-based experience during the summer break, satisfied the NIDR requirements for research exposure and the grant renewal was approved.

Dr. Dennis Lopatin

In 1987, Walter Loesche, professor and director of research, created what was called the UM–OSU Research Duel. The duel, coordinated by Biologic and Materials Sciences faculty member Dennis Lopatin and Samuel Rosen at The Ohio State University (OSU) Dental School, was a Table Clinic competition held annually between predoctoral students of both schools. The host school alternated from year to year, one year in Ann Arbor and the next year in Columbus. [9]

Jason Golnick (DDS 1994, MS PedDent 2003) with his U-M/ OSU Research Duel poster.

Students from each school’s student research program were selected to present their research in a “friendly” competition, judged by faculty members from both schools. Of interest, one of the OSU judges was a junior faculty member, Dr. Laurie McCauley, who in 2013 would be named dean of the U-M School of Dentistry. While there was a “traveling” plaque recording the winner of each duel, the true benefit of the duel was the experience the students gained in discussing their research with other faculty and students and getting a glimpse of what learning dentistry was like at the host school.

David Gratton (DDS 1994) with his U-M /OSU Research Duel poster.

Preparing for the Future

To prepare dental students for the challenges of the 1990s and beyond, Kotowicz often emphasized to students, faculty, and alumni that dentistry was on a new path. It was evolving from a primarily technical profession (“drill and fill”) to one that combined advances in dentistry, medicine, biology, and other areas of science; and that it was vital for U-M dental students to be prepared. The new curriculum was designed to educate highly competent practitioners in an environment that mirrored a general dental practice.

In line with that thinking and realizing the importance of collaboration with other schools and colleges, Kotowicz reached out to utilize the resources available throughout the rest of the U-M. This included collaboration with the School of Public Health, the College of Pharmacy, and the College of Engineering. More involvement with the Medical School was also initiated in areas that included geriatrics and oncology.[7]

The dental hygiene program also experienced changes during this time. Professor Pauline Steele retired in 1988 after 20 years of service and was succeeded by Professor Wendy Kerschbaum. Kerschbaum was the third director of the dental hygiene program since its launch and held that position until 2012, when she was succeeded by Professor Janet Kinney.

Professor Pauline Steele

Professor Wendy Kerschbaum

Recruiting Faculty

A drive to increase the number of faculty members to teach both academic dentistry and clinical dentistry was a high priority. In the early 1970s, most faculty members were part-time instructors and had their own private practice. Finding qualified young faculty members to teach at the School of Dentistry was difficult. In many instances, dental practitioners had built their practices and were hesitant to leave for salary levels that were lower in academia than in private practice.[10]

In 1972, the school’s faculty totaled 239 (both part time and full time). Included in that number were 71 clinical instructors, 50 assistant professors, 49 professors, 25 clinical assistant professors, 23 associate professors, 7 instructors, 7 lecturers, 4 visiting assistant professors, and 3 clinical professors. Not included in those numbers were 20 Medical School faculty members who also taught at the dental school.[11]

Faculty recruitment efforts began in earnest in 1988 with searches in periodontics, operative dentistry, prosthodontics, biologic and materials sciences, and occlusion. Kotowicz said the positions would not be easy to fill and that candidates “must be superior teachers with strong research potential.”[7]

Reflections

The school, guided by the Transition Committee and the efforts of various task force groups, proceeded with initiatives essential to the future success of the dental school. The departmental and administrative structures were reorganized. The dental school bylaws were written and executed, the promotion and tenure document was created, curricular changes were implemented, comprehensive care was introduced, and the budget was balanced. Kotowicz was confident that a new dean “would be named or in place” by the fall of 1989 and felt that these initiatives would “provide an excellent base for a permanent dean.”[7]

On June 29, 1989, U-M Provost Charles Vest came to the Kellogg Auditorium to announce that J. Bernard Machen, associate dean of the School of Dentistry at the University of North Carolina—Chapel Hill, would become the new dean of the U-M School of Dentistry on October 1. Vest also praised Kotowicz: “Bill has risen to this occasion and has just performed, I believe, an outstanding service to this school, the university and the profession.”[12]